On March 21, 38-year-old Jim Santilli thought he was going to die. Lying in the hospital in Clinton Township, Mich., with COVID-19, he gasped for air and felt like he was slowly drowning. Then, an infectious disease specialist decided to give him a combination of the anti-malarial drug hydroxychloroquine and the widely used antibiotic azithromycin.
“Within a few hours after receiving the first dose, I had a drastic improvement, almost a 180-degree turn,” Santilli told Laura Ingraham on Fox News. “I had hope at that point.”
In the frantic quest to treat COVID-19, some scientists focus on repurposing existing drugs like those Santilli received, while others explore new methods of treatment as the pressure grows to get something into doctors’ hands.
The U.S. Food and Drug Administration gave emergency approval for patients hospitalized with COVID-19 to receive hydroxychloroquine and another anti-malarial, chloroquine. Some small studies have shown positive results from the medications. Researchers in China claimed the drugs worked but have not released their data. A large clinical trial is also underway in New York. But hydroxychloroquine may cause harmful side effects, like heart damage, said David Smith, an infectious disease physician at the University of California San Diego. “This is a warning signal, but we still need to do the trial,” he told Science magazine.
Scientists are testing other potential treatments, as well. One anti-viral drug, called favipiravir, or Avigan, showed positive results in Chinese clinical trials, The Guardian reported. Patients who received the drug tested negative for the coronavirus a week earlier on average than those who received standard treatment. But, like many anti-virals, the drug appears most effective in the earliest stages of the disease and doesn’t work as well in more severe cases.
Some doctors are trying an immunosuppressant drug approved for the treatment of rheumatoid arthritis on COVID-19 patients whose immune systems go into overdrive and attack their own tissue, which can be fatal. Roche announced on March 19 that it would start testing the drug, tocilizumab (Actemra), in early April. Another company, Regeneron, said it began a global clinical trial for a similar drug, sarilumab (Kevzara).
This month, researchers could release results from two of five large clinical studies of Gilead Sciences’ Ebola anti-viral remdesivir, Stat reported. But the medical community could have a hard time administering the drug. Because the FDA has not approved it for general use, only the sickest patients can get it by participating in clinical trials. Like most drugs used to treat infections, remdesivir likely works much better when given during the early stage of the illness, Stanley Perlman, a coronavirus researcher at the University of Iowa, told Science. But with remdesivir, he said, “you can’t do that because it’s an intravenous drug, it’s expensive, and 85 out of 100 people don’t need it” because their illness won’t become severe.
On March 20, the World Health Organization announced a study involving more than 45 countries to test four potential drugs and drug combinations: remdesivir; chloroquine and hydroxychloroquine; the HIV drugs lopinavir plus ritonavir; and lopinavir and ritonavir in combination with interferon-beta, an anti-inflammatory. Last week, Norway enrolled the first person in the study, which matches patients with one of the four treatments and tracks whether they get better.
“We are in a middle of a global health emergency,” Norweigian Minister of Health Bent Høie said. “We are also in the middle of a global quest for knowledge unlike anything we have ever seen. If you find treatments that are safe and effective, we can save lives and we can protect healthcare professionals and other high-risk groups from developing disease.”